Symptoms

What are the symptoms of botulism?The classic symptoms of botulism include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness. Infants with botulism appear lethargic, feed poorly, are constipated, and have a weak cry and poor muscle tone. These are all symptoms resulting from muscle paralysis caused by the bacterial toxin. If untreated, these symptoms may progress to paralysis of the arms, legs, trunk and respiratory muscles. In foodborne botulism, symptoms generally begin 18 to 36 hours after eating a contaminated food, but can occur as early as 6 hours or as late as 10 days after exposure.

How is botulism diagnosed?The most direct way to confirm the diagnosis of botulism is to test for botulism toxin in a patient’s blood or stool, by injecting blood or stool into mice and watching for signs of botulism. The bacteria can also be isolated from the stool of people with foodborne and infant botulism. These tests can be performed at some state health department and at Centers for Disease Control (CDC) laboratories.

How can botulism be treated?The respiratory failure and paralysis that occur with severe botulism may require a patient to be on a breathing machine for weeks, plus intensive medical and nursing care. After several weeks, the paralysis slowly improves.

If diagnosed early, botulism can be treated with an antitoxin that blocks the actions of the toxin circulating in the blood. This can prevent patients from worsening, but recovery still takes many weeks. Physicians may try to remove contaminated food remaining in the gut by inducing vomiting or by using enemas. Wounds should be treated, usually surgically, to remove the source of the toxin-producing bacteria. Good supportive care in a hospital is the core therapy for all forms of botulism.

The bacterium Clostridium botulinum is the same bacterium that is used to produce Botox or Myobloc, pharmaceuticals for clinical and cosmetic use. However, what is used in Botox treatments is the purified and diluted neurotoxin A. Treatment is administered according to the needs and tolerance of the patient.